Negative Response Bias in a Disability and Civil Liability Claim setting: A Dutch Study on Prevalence Rates and Associations with Neuropsychological Test Outcomes

Tjerk Schoemaker, Anne-Eva Stevens, Dick Lam, Jaap van der Veer, Sascha Meyer and Jos F De Jonghe*

Symptom over-endorsement and underperformance make up negative response bias during (NRB) neuropsychological assessments. Most NRB prevalence studies in a disability or liability claim setting are confined to the US. This Dutch study examined NRB in cases with a suspected or established general medical, neurological, traumatic brain injury, or psychiatric diagnosis, and examined effects on cognitive and self-reported outcomes. Archival data were used to compare neuropsychological test results and self-rated depression across groups with or without NRB. A total of 393 cases were included in the study. NRB was present in 48.3% of cases, with a higher prevalence in the psychiatric sub-sample (63.4%), as compared to the neurological sub-sample (18.6%). Subjects who underperformed generally yielded low scores on all neuropsychological tests, and effect sizes ranged from medium to large. NRB was independently associated with self-rated depression, and the effect size was large (Partial Eta2 =0.165). This large Dutch study shows that NRB is highly prevalent in a disability and liability claim setting, particularly in cases referred with an established or suspected psychiatric diagnosis. Not recognizing NRB in time may lead to invalid diagnostic conclusions and excess financial costs to society.

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Published on: Apr 24, 2026 Pages: 1-6

Full Text PDF Full Text HTML DOI: 10.17352/ach.000039
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